Can we at least have a degree of socialism in our society?

kimmiinthemitten · September 2015

kkitkat79 said:

monkeysip said:

What bothers me is how a lot of people start frothing at the mouth at the mere mention of anything socialist.

I don't think our entire society should be socialist either, BUT that doesn't mean that it's not better for the government to run SOME industries. I think there's good arguments to be made that healthcare is a public good, and therefore operates better under a single payer system. That doesn't mean that we all have to start being Marxist and calling each other comrade. But a lot of people think anything and everything socialist is the devil.

That's why even though I support Bernie Sanders on most things, I honestly don't think he could win. He's a "dirty socialist" in so many people's eyes.

I think you are right in that people often have an almost Pavlovian response to the word socialism. I also think that the word is often misused to mean something other than what it actually means.

That said, I had first hand experience with socialism. It was not good. I can't think of one example where a publicly-run industry outperforms a free-entry privately-run industry.

Yeah the same people foaming at the mouth at Bernie Sanders for being the S word are the same people posting "Police Lives Matter" memes on their facebook page and don't even recognize their own hypocrisy (shocking). And he's a Democratic Socialist, not a Socialist. There is a difference.

kkitkat79 · September 2015

STARMOON44 said:

In Russia? That was communism. Or Israel? Or Canada? The NHS certainly outperforms our health care industry if you care about poor people not dying for lack of basic care.

I mean Russia. By definition all communist countries are also socialist countries, but not all socialist countries are communist countries. So yes, I do have first hand experience with socialism. Not good.

If you want to compare healthcare systems here is a ranking by WHO and another one by Bloomberg. According to both neither Canada nor US make it to top 20. So maybe it's time to see what other countries are doing. I think the details matter a great deal.

I have to note that these rankings measure different things. WHO measures overall health system performance in relation to a set of goals: health, responsiveness, and fairness in financing and financial risk protection.

Bloomberg measures healthcare system performance only in terms of efficiency.

lyndausvi · September 2015

princessleia22 said:

kimmiandkoley said:

"For instance, according to a 2013 report released by the International Federation of Health Plans, Nexium – the “purple pill” commonly prescribed for acid reflux – cost more than $200 for U.S. patients in 2013 and only $60 in Switzerland, the next-most-expensive price in the world for the same drug. In the Netherlands, it cost $23."

Yet somehow all these pharma companies sell the exact same drug to patients in other countries for far less than they sell them here. I'm all for people making money, but when the product you sell benefits the greater good for literally all of human kind, there need to be caps on how much you profit from those products. Trickle down clearly is not a thing.

@Feeleytobe I love you more and more each post;)

My husband has a medication that was costing him $100 a month ... for a generic. He went to a new doctor that recommended a mail-order pharmacy out of Canada... the pills actually got mailed from India, though... but, it costs him $20 a month now.

My big glaring example that pisses me off with the unfairness of medical costs, is the insured vs. uninsured rates on everything. A few years ago I had about a 6-month lapse in medical insurance. During that time I needed to get a physical exam & standard blood work, in order to continue refilling one of my necessary medications. The exam cost was minimal and I figured that the amount I had typically seen on my bills for blood work was around $50. Well, then my non-insured bills came... it cost over $600 for the same lab tests that had cost me $50 the year before. Just because I didn't have an insurance negotiated rate for the tests. Of course you get uninsured skipping out on paying if you gouge them like that! If you charged them same cost as insured people, there may be higher chance of payment. Of course, that may not apply the same with large bills for surgery or whatnot... some of those costs are so high that it's impossible to pay without insurance.

my DH has to have some tests to see if his aneurysm has grown. In Indy the tests and doctor visits would cost about $4K. Now that we have moved those costs are about $2k. Same tests, half the cost. Plus our insurance is better here, so our out-of-pocket costs are lower too.

novella1186 · September 2015

princessleia22 said:

kimmiandkoley said:

"For instance, according to a 2013 report released by the International Federation of Health Plans, Nexium – the “purple pill” commonly prescribed for acid reflux – cost more than $200 for U.S. patients in 2013 and only $60 in Switzerland, the next-most-expensive price in the world for the same drug. In the Netherlands, it cost $23."

Yet somehow all these pharma companies sell the exact same drug to patients in other countries for far less than they sell them here. I'm all for people making money, but when the product you sell benefits the greater good for literally all of human kind, there need to be caps on how much you profit from those products. Trickle down clearly is not a thing.

@Feeleytobe I love you more and more each post;)

My husband has a medication that was costing him $100 a month ... for a generic. He went to a new doctor that recommended a mail-order pharmacy out of Canada... the pills actually got mailed from India, though... but, it costs him $20 a month now.

My big glaring example that pisses me off with the unfairness of medical costs, is the insured vs. uninsured rates on everything. A few years ago I had about a 6-month lapse in medical insurance. During that time I needed to get a physical exam & standard blood work, in order to continue refilling one of my necessary medications. The exam cost was minimal and I figured that the amount I had typically seen on my bills for blood work was around $50. Well, then my non-insured bills came... it cost over $600 for the same lab tests that had cost me $50 the year before. Just because I didn't have an insurance negotiated rate for the tests. Of course you get uninsured skipping out on paying if you gouge them like that! If you charged them same cost as insured people, there may be higher chance of payment. Of course, that may not apply the same with large bills for surgery or whatnot... some of those costs are so high that it's impossible to pay without insurance.

On the flip side of that, I have insurance and was recently charged $6,000 for an ER visit. A lawyer told me that hospitals will jack up costs assuming insurance will pick up most of it so they'll get paid in order to offset the uninsured people who don't pay at all. No idea if that's true, but either way, it sucks. Like I said in an earlier post, medical spending in the US is just fucked up across the board.

STARMOON44 · September 2015

kkitkat79 said:

STARMOON44 said:

kkitkat79 said:

In Russia? That was communism. Or Israel? Or Canada?

The NHS certainly outperforms our health care industry if you care about poor people not dying for lack of basic care.

I mean Russia. By definition all communist countries are also socialist countries, but not all socialist countries are communist countries. So yes, I do have first hand experience with socialism. Not good.

If you want to compare healthcare systems here is a ranking by WHO and another one by Bloomberg. According to both neither Canada nor US make it to top 20. So maybe it's time to see what other countries are doing. I think the details matter a great deal.

I have to note that these rankings measure different things. WHO measures overall health system performance in relation to a set of goals: health, responsiveness, and fairness in financing and financial risk protection.

Bloomberg measures healthcare system performance only in terms of efficiency.

Nonsense. It's absurd to claim you have experience with socialism because of soviet Russia. But what else is new with you. Reality is not your homeland.

princessleia22 · September 2015

novella1186 said:

princessleia22 said:

kimmiandkoley said:

"For instance, according to a 2013 report released by the International Federation of Health Plans, Nexium – the “purple pill” commonly prescribed for acid reflux – cost more than $200 for U.S. patients in 2013 and only $60 in Switzerland, the next-most-expensive price in the world for the same drug. In the Netherlands, it cost $23."

Yet somehow all these pharma companies sell the exact same drug to patients in other countries for far less than they sell them here. I'm all for people making money, but when the product you sell benefits the greater good for literally all of human kind, there need to be caps on how much you profit from those products. Trickle down clearly is not a thing.

@Feeleytobe I love you more and more each post;)

My husband has a medication that was costing him $100 a month ... for a generic. He went to a new doctor that recommended a mail-order pharmacy out of Canada... the pills actually got mailed from India, though... but, it costs him $20 a month now.

My big glaring example that pisses me off with the unfairness of medical costs, is the insured vs. uninsured rates on everything. A few years ago I had about a 6-month lapse in medical insurance. During that time I needed to get a physical exam & standard blood work, in order to continue refilling one of my necessary medications. The exam cost was minimal and I figured that the amount I had typically seen on my bills for blood work was around $50. Well, then my non-insured bills came... it cost over $600 for the same lab tests that had cost me $50 the year before. Just because I didn't have an insurance negotiated rate for the tests. Of course you get uninsured skipping out on paying if you gouge them like that! If you charged them same cost as insured people, there may be higher chance of payment. Of course, that may not apply the same with large bills for surgery or whatnot... some of those costs are so high that it's impossible to pay without insurance.

On the flip side of that, I have insurance and was recently charged $6,000 for an ER visit. A lawyer told me that hospitals will jack up costs assuming insurance will pick up most of it so they'll get paid in order to offset the uninsured people who don't pay at all. No idea if that's true, but either way, it sucks. Like I said in an earlier post, medical spending in the US is just fucked up across the board.

My current doctor office uses a lab that sends a huge bill to the insurance company... like $2k for the same lab work I mentioned previously. Then, the insurance company mails a check TO ME for whatever they think is the appropriate cost. I forward that check to the lab and they write off whatever amount the insurance didn't pay. So, it's really just throw a number out there and see what sticks. I've debated switching doctors or requesting that my doctor send it to a different lab, because I totally think it's ridiculous and bordering on legalized fraud. There are so many ways our system is flawed.

TrixieJess · September 2015

monkeysip said:

I would argue that healthcare is better in countries like Canada with socialized healthcare. Americans have poorer health than many other developed nations despite the fact that we pay so much more for healthcare per capita.

You'd be wrong. We have higher rates of waiting times for surgeries and specialists. We also pay more money for our pharmaceuticals and have to wait longer for drugs to be approved. We also have to pay out of pocket for a lot of things as certain components of health care become delisted.

Don't even get me started on the attrition rate for nurses and family doctors. There are also lots of communities that don't have hospitals, family doctors etc.

There is something to be said about paying for service, it's just that a happy medium between what you pay for and what the Government pays for would be nice.

MyNameIsNot · September 2015

novella1186 said:

princessleia22 said:

kimmiandkoley said:

"For instance, according to a 2013 report released by the International Federation of Health Plans, Nexium – the “purple pill” commonly prescribed for acid reflux – cost more than $200 for U.S. patients in 2013 and only $60 in Switzerland, the next-most-expensive price in the world for the same drug. In the Netherlands, it cost $23."

Yet somehow all these pharma companies sell the exact same drug to patients in other countries for far less than they sell them here. I'm all for people making money, but when the product you sell benefits the greater good for literally all of human kind, there need to be caps on how much you profit from those products. Trickle down clearly is not a thing.

@Feeleytobe I love you more and more each post;)

My husband has a medication that was costing him $100 a month ... for a generic. He went to a new doctor that recommended a mail-order pharmacy out of Canada... the pills actually got mailed from India, though... but, it costs him $20 a month now.

My big glaring example that pisses me off with the unfairness of medical costs, is the insured vs. uninsured rates on everything. A few years ago I had about a 6-month lapse in medical insurance. During that time I needed to get a physical exam & standard blood work, in order to continue refilling one of my necessary medications. The exam cost was minimal and I figured that the amount I had typically seen on my bills for blood work was around $50. Well, then my non-insured bills came... it cost over $600 for the same lab tests that had cost me $50 the year before. Just because I didn't have an insurance negotiated rate for the tests. Of course you get uninsured skipping out on paying if you gouge them like that! If you charged them same cost as insured people, there may be higher chance of payment. Of course, that may not apply the same with large bills for surgery or whatnot... some of those costs are so high that it's impossible to pay without insurance.

On the flip side of that, I have insurance and was recently charged $6,000 for an ER visit. A lawyer told me that hospitals will jack up costs assuming insurance will pick up most of it so they'll get paid in order to offset the uninsured people who don't pay at all. No idea if that's true, but either way, it sucks. Like I said in an earlier post, medical spending in the US is just fucked up across the board.

Yep. I worked at a hospital in the billing department for a short stint in college. The hospital would intentionally bill insurance companies that didn't have negotiated rates at some absurdly high rate. Then when insurance paid some portion, they'd take it and write off the difference.

The same hospital also offered a "standard discount" where any uninsured patient that called in about their bill would get a 10-25% discount (depending on the total amount) right out of the gate if they made a payment.

With the exception of standard co-pays, I never pay medical bills without calling first, covered by insurance or not. I had no idea how much they'll agree to write stuff off just because you ask.

onefootinthebayou · September 2015

Here are my thoughts on this.

1. This guy is a dick, but this is a case of cherry picking one outrageous case towards the ever-present trend of being "outraged" at things on Facebook, (which admittedly is where I read about it today) as well as at the "evil" pharmaceutical industry. People working for pennies to build your smart phones? = Steve Jobs is a god. Companies like Biogen donating a billion doses to hemophiliacs around the world get *crickets* - no applause to rival the outrage this story gets. This enrages me as someone who's dedicated all of my studies and my entire career to this industry that people with no experience or knowledge of so freely vilify as it suits them based on something they read in the paper.

2. The existence of a therapy does not equal a RIGHT to that therapy. Somebody has to make it, test it, pass FDA inspections, ship it, sell it etc. The original company decided a product wasn't worth the effort anymore. What If nobody bought the rights and the drug simply ceased production altogether?

3. There's no patent protection, so if this molecule proves to be profitable there will be generic competition in a year. After that, the market and competition will drive the price down to something more affordable, yet still commercially viable.

4. In the meantime, insurance companies will pay, just like they do for $50 Tylenol at the hospital.

5. The government can set up a shop to make these low-profit drugs, but that would mean taxes (and subsequent outrage), and then one would ask how the FDA would be fair to another govt agency. "This guy's greedy" is an oversimplification of a more complicated topic. I still think that guy's a dick but I have no patience with people who paint an entire industry (that has spent billions to develop and bring life-saving and life-enhancing medications to the worldwide population) with the same ignorant brush.

This case illustrates a number of issues in this country that are worthy of serious discussion, but discussion based on first understanding the forces at play. Unfortunately, as the outrage du jour, I don't see this story resulting in much good. Facebook gives everyone a voice, but who's checking the facts? Who's doing more than expressing "outrage"? Reminds me: Hey, what ever happened to that "Occupy Wall Street" thing?

kkitkat79 · September 2015

STARMOON44 said:

STARMOON44 said:

In Russia? That was communism. Or Israel? Or Canada? The NHS certainly outperforms our health care industry if you care about poor people not dying for lack of basic care.

I mean Russia. By definition all communist countries are also socialist countries, but not all socialist countries are communist countries. So yes, I do have first hand experience with socialism. Not good.

Nonsense. It's absurd to claim you have experience with socialism because of soviet Russia. But what else is new with you. Reality is not your homeland.

Look, socialism is essentially an economic system that can exist in various forms under different political regimes. My experience was exactly that - a form of socialism. You can argue that it is not the only form possible. That's is definitely debatable. But for you to say that I had no experience with socialism - that is absurd.

STARMOON44 · September 2015

kkitkat79 said:

STARMOON44 said:

STARMOON44 said:

kkitkat79 said:

In Russia? That was communism. Or Israel? Or Canada?

The NHS certainly outperforms our health care industry if you care about poor people not dying for lack of basic care.

I mean Russia. By definition all communist countries are also socialist countries, but not all socialist countries are communist countries. So yes, I do have first hand experience with socialism. Not good.

Nonsense. It's absurd to claim you have experience with socialism because of soviet Russia. But what else is new with you. Reality is not your homeland.

Look, socialism is essentially an economic system that can exist in various forms under different political regimes. My experience was exactly that - a form of socialism. You can argue that it is not the only form possible. That's is definitely debatable. But for you to say that I had no experience with socialism - that is absurd.

You may as well argue that soviet Russia was really just a particularly bad form of capitalism.

monkeysip · September 2015

TrixieJess said:

monkeysip said:

I would argue that healthcare is better in countries like Canada with socialized healthcare. Americans have poorer health than many other developed nations despite the fact that we pay so much more for healthcare per capita.

You'd be wrong. We have higher rates of waiting times for surgeries and specialists. We also pay more money for our pharmaceuticals and have to wait longer for drugs to be approved. We also have to pay out of pocket for a lot of things as certain components of health care become delisted.

Don't even get me started on the attrition rate for nurses and family doctors. There are also lots of communities that don't have hospitals, family doctors etc.

There is something to be said about paying for service, it's just that a happy medium between what you pay for and what the Government pays for would be nice.

I admit I'm not as knowledgable on Canada's rates for these things, so Canada might be a poor example to choose on my part. I definitely am not saying that socialized medicine is perfect. But I also think the entire American health insurance system is an overcomplicated mess.

I agree that paying for a service can be important, especially since if you're not paying for it, you tend to OVERUSE healthcare (getting unnecessary treatments and tests done). If you're paying for it, you will only use as much healthcare as outweighs the marginal cost. The problem with the American style health insurance system though is that patients still overuse (because they don't feel that they're paying for it) and doctors sometimes oversupply (to rack up the insurance bill). All this drives up cost to outrageous amounts.

kkitkat79 · September 2015

STARMOON44 said:

STARMOON44 said:

STARMOON44 said:

In Russia? That was communism. Or Israel? Or Canada? The NHS certainly outperforms our health care industry if you care about poor people not dying for lack of basic care.

I mean Russia. By definition all communist countries are also socialist countries, but not all socialist countries are communist countries. So yes, I do have first hand experience with socialism. Not good.

Nonsense. It's absurd to claim you have experience with socialism because of soviet Russia. But what else is new with you. Reality is not your homeland.

Look, socialism is essentially an economic system that can exist in various forms under different political regimes. My experience was exactly that - a form of socialism. You can argue that it is not the only form possible. That's is definitely debatable. But for you to say that I had no experience with socialism - that is absurd.
You may as well argue that soviet Russia was really just a particularly bad form of capitalism.

Capitalism is an economic system in which the means of production are privately owned. Socialism is an economic system in which the means of production are owned in common. So no, I cannot argue that soviet Russia was a bad form of capitalism. The means of production were owned by the state. You can differentiate between private ownership and state ownership, right?

huskypuppy14 · September 2015

onefootinthebayou said:

Here are my thoughts on this.

1. This guy is a dick, but this is a case of cherry picking one outrageous case towards the ever-present trend of being "outraged" at things on Facebook, (which admittedly is where I read about it today) as well as at the "evil" pharmaceutical industry. People working for pennies to build your smart phones? = Steve Jobs is a god. Companies like Biogen donating a billion doses to hemophiliacs around the world get *crickets* - no applause to rival the outrage this story gets. This enrages me as someone who's dedicated all of my studies and my entire career to this industry that people with no experience or knowledge of so freely vilify as it suits them based on something they read in the paper.

2. The existence of a therapy does not equal a RIGHT to that therapy. Somebody has to make it, test it, pass FDA inspections, ship it, sell it etc. The original company decided a product wasn't worth the effort anymore. What If nobody bought the rights and the drug simply ceased production altogether?
3. There's no patent protection, so if this molecule proves to be profitable there will be generic competition in a year. After that, the market and competition will drive the price down to something more affordable, yet still commercially viable.
4. In the meantime, insurance companies will pay, just like they do for $50 Tylenol at the hospital.
5. The government can set up a shop to make these low-profit drugs, but that would mean taxes (and subsequent outrage), and then one would ask how the FDA would be fair to another govt agency. "This guy's greedy" is an oversimplification of a more complicated topic. I still think that guy's a dick but I have no patience with people who paint an entire industry (that has spent billions to develop and bring life-saving and life-enhancing medications to the worldwide population) with the same ignorant brush.
This case illustrates a number of issues in this country that are worthy of serious discussion, but discussion based on first understanding the forces at play. Unfortunately, as the outrage du jour, I don't see this story resulting in much good. Facebook gives everyone a voice, but who's checking the facts? Who's doing more than expressing "outrage"? Reminds me: Hey, what ever happened to that "Occupy Wall Street" thing?

This! Thank you.

Many of you have no idea what you are talking about. Feely-you really think scientists are keeping the cancer cure a secret? That's one of the most ridiculous things I've ever heard. Do you even understand how many scientists and companies are working on curing/treating cancer? Do you even know how the industry works? And it's not just the big bad pharmaceutical companies, academic institutions around the world are trying to treat/cure it. Many many scientists are not in it for the money, but the recognition. If you are the scientist that cures cancer, that is something money can't buy. Sure, there are always going to be greedy SOBs, but the many people working to treat all these diseases, do it to help people.

I work for a company, where patients are the primary driver. We don't have a product to market yet, but we have many people working on how we will market it and what the cost will be. The 20 year patent starts when you file the patent, not when it goes to market. So my company already has years ticked off the clock on certain patents. The reality is most companies only have 7-12 years (if they're lucky) of true exclusivity once on the market. We've spent hundreds of millions of dollars on R&D already, and we are only in clinical trials. Clinical trials are a huge cost for the company as well. By the time a drug goes to market, you could have already spent over a billion dollars. Where does the up front money come from, investors. The investors eventually want to get a return on their money.

I'm not saying what this guy did is right, no he sounds like a huge dick, but don't start spreading lies and rumors that this applies to all companies.

STARMOON44 · September 2015

kkitkat79 said:

STARMOON44 said:

kkitkat79 said:

STARMOON44 said:

STARMOON44 said:

kkitkat79 said:

In Russia? That was communism. Or Israel? Or Canada?

The NHS certainly outperforms our health care industry if you care about poor people not dying for lack of basic care.

I mean Russia. By definition all communist countries are also socialist countries, but not all socialist countries are communist countries. So yes, I do have first hand experience with socialism. Not good.

Nonsense. It's absurd to claim you have experience with socialism because of soviet Russia. But what else is new with you. Reality is not your homeland.

Look, socialism is essentially an economic system that can exist in various forms under different political regimes. My experience was exactly that - a form of socialism. You can argue that it is not the only form possible. That's is definitely debatable. But for you to say that I had no experience with socialism - that is absurd.

You may as well argue that soviet Russia was really just a particularly bad form of capitalism.

Capitalism is an economic system in which the means of production are privately owned. Socialism is an economic system in which the means of production are owned in common. So no, I cannot argue that soviet Russia was a bad form of capitalism. The means of production were owned by the state. You can differentiate between private ownership and state ownership, right?

Just as well as you can between socialism and communism!

LadyMillil · September 2015

FeeleyToBe said:

This is already happening with cancer cures I think. My fiance is a Pharmacy Tech and was telling me that because the money is not in the cure but in the treatment, pharmaceutical companies have simply made the few cure drugs completely unaffordable to keep them off the market.

Sad, sad, sad.

P.S. If you're truly upset with Pharmaceutical Greed, look into Bernie Sanders for POTUS.

kkitkat79 · September 2015

I don't think there is anything wrong with running a business for profit. What is wrong is asking for special protections under the guise of being somehow different. There is no evidence that lack of monopolistic power decreases innovation. There is evidence, however, that monopolistic power leads to industry concentration and less innovation.

The 10 largest drug companies control over one-third of the drug market. Their profit margins are about 30 per cent. They spend about one-third of all sales revenue on marketing - twice what they spend on R&D. So they drive out smaller companies, make more money, and spend less of it on innovation. I don't see how that is a good thing.

huskypuppy14 · September 2015

kkitkat79 said:

I don't think there is anything wrong with running a business for profit. What is wrong is asking for special protections under the guise of being somehow different. There is no evidence that lack of monopolistic power decreases innovation. There is evidence, however, that monopolistic power leads to industry concentration and less innovation.

The 10 largest drug companies control over one-third of the drug market. Their profit margins are about 30 per cent. They spend about one-third of all sales revenue on marketing - twice what they spend on R&D. So they drive out smaller companies, make more money, and spend less of it on innovation. I don't see how that is a good thing.

How do they drive out smaller companies? Innovation also comes from academics too.

What does happen is the start ups do the innovation, and then the larger companies buy out the smaller companies.

kkitkat79 · September 2015

huskypuppy14 said:

kkitkat79 said:

I don't think there is anything wrong with running a business for profit. What is wrong is asking for special protections under the guise of being somehow different. There is no evidence that lack of monopolistic power decreases innovation. There is evidence, however, that monopolistic power leads to industry concentration and less innovation.

The 10 largest drug companies control over one-third of the drug market. Their profit margins are about 30 per cent. They spend about one-third of all sales revenue on marketing - twice what they spend on R&D. So they drive out smaller companies, make more money, and spend less of it on innovation. I don't see how that is a good thing.

How do they drive out smaller companies? Innovation also comes from academics too.

What does happen is the start ups do the innovation, and then the larger companies buy out the smaller companies.

You can see how this contributes to industry concentration, right? This is what I mean when I say that big pharmaceutical companies drive out the smaller companies.

huskypuppy14 · September 2015

kkitkat79 said:

huskypuppy14 said:

kkitkat79 said:

I don't think there is anything wrong with running a business for profit. What is wrong is asking for special protections under the guise of being somehow different. There is no evidence that lack of monopolistic power decreases innovation. There is evidence, however, that monopolistic power leads to industry concentration and less innovation.

The 10 largest drug companies control over one-third of the drug market. Their profit margins are about 30 per cent. They spend about one-third of all sales revenue on marketing - twice what they spend on R&D. So they drive out smaller companies, make more money, and spend less of it on innovation. I don't see how that is a good thing.

How do they drive out smaller companies? Innovation also comes from academics too.

What does happen is the start ups do the innovation, and then the larger companies buy out the smaller companies.

You can see how this contributes to industry concentration, right? This is what I mean when I say that big pharmaceutical companies drive out the smaller companies.

Your comment was how large companies aren't innovative though. Companies aren't innovative, it's the scientist/individuals within the company that have the ideas. The company has the resources to implement the ideas, but the ideas come from people. Many of the innovative people want to work for an innovative company, which you are correct isn't necessarily the large companies. When companies get bought out, the people in research at the smaller company that was just bought, get laid off (with good packages, and most likely greater stock). Then if they want, they go work for another startup, or start another company. It's a great big circle.

And sometimes, the smaller companies, become bigger companies.

If you want to discuss monopolies, that's a different discussion.

onefootinthebayou · September 2015

huskypuppy14 said:

kkitkat79 said:

I don't think there is anything wrong with running a business for profit. What is wrong is asking for special protections under the guise of being somehow different. There is no evidence that lack of monopolistic power decreases innovation. There is evidence, however, that monopolistic power leads to industry concentration and less innovation.

The 10 largest drug companies control over one-third of the drug market. Their profit margins are about 30 per cent. They spend about one-third of all sales revenue on marketing - twice what they spend on R&D. So they drive out smaller companies, make more money, and spend less of it on innovation. I don't see how that is a good thing.

How do they drive out smaller companies? Innovation also comes from academics too.

What does happen is the start ups do the innovation, and then the larger companies buy out the smaller companies.

This exactly. And let's not forget licensing deals. There is a whole industry niche dedicated to forming licensing deals between Big Pharma and small biotech. Perhaps a Big Pharma company doesn't want to acquire an entire start-up or biotech but is interested in acquiring rights to one or more of their compounds to bring further into development and/or to market. Now it's the small biotech's turn to bring their brass balls to the negotiating table and negotiate a deal with the Big Pharma company that includes lots of money for development of this compound, milestone payments, etc. Then the Big Pharma company takes the compound through clinical trials (assuming the risk here as well), launches it commercially, and if the small biotech negotiated a good deal, they will continue to receive royalties from a now commercial drug that they could not have had the resources to bring to market without a Baxter or a Bayer or a Purdue's robust wallet. I would hardly call this choking innovation of small biotech. I call it symbiosis.

novella1186 · September 2015

onefootinthebayou said:

huskypuppy14 said:

kkitkat79 said:

I don't think there is anything wrong with running a business for profit. What is wrong is asking for special protections under the guise of being somehow different. There is no evidence that lack of monopolistic power decreases innovation. There is evidence, however, that monopolistic power leads to industry concentration and less innovation.

The 10 largest drug companies control over one-third of the drug market. Their profit margins are about 30 per cent. They spend about one-third of all sales revenue on marketing - twice what they spend on R&D. So they drive out smaller companies, make more money, and spend less of it on innovation. I don't see how that is a good thing.

How do they drive out smaller companies? Innovation also comes from academics too.

What does happen is the start ups do the innovation, and then the larger companies buy out the smaller companies.

This exactly. And let's not forget licensing deals. There is a whole industry niche dedicated to forming licensing deals between Big Pharma and small biotech. Perhaps a Big Pharma company doesn't want to acquire an entire start-up or biotech but is interested in acquiring rights to one or more of their compounds to bring further into development and/or to market. Now it's the small biotech's turn to bring their brass balls to the negotiating table and negotiate a deal with the Big Pharma company that includes lots of money for development of this compound, milestone payments, etc. Then the Big Pharma company takes the compound through clinical trials (assuming the risk here as well), launches it commercially, and if the small biotech negotiated a good deal, they will continue to receive royalties from a now commercial drug that they could not have had the resources to bring to market without a Baxter or a Bayer or a Purdue's robust wallet. I would hardly call this choking innovation of small biotech. I call it symbiosis.

There are lots of small start-ups in this area whose main goal is to create a product that my company will buy the rights to. If they make something amazing, we do buy it. Happens all the time. They take their huge check and invest it back into further innovation or sometimes they come work for us.

But my company also innovates. We launch multiple new products every single year; either brand new things the world has never seen before, or we've improved an established product. Our engineers and designers (and we have a LOT of them) are constantly focused on how to improve, innovate, bring the patient something new and better and safer. They never stop innovating. Which is exactly how this company became the world leader in market share and (thanks to our recent merger) the biggest company of our kind in the world.

In this industry things are really competitive, and trends move fast. Trying to keep up definitely drives innovation and creation.

Our competitors who do not innovate get left behind. The end goal is delivering something amazing to the patient and if you can't keep up with how fast the market moves and you can't come out with new and better products, you lose. In fact, the companies who have lost market share in recent years and have downsized or been bought out are those who put something inferior on the market that led to recalls and harming patients.

So just because a company is big does not mean it is crushing innovation.

Wegl13 · September 2015

Capitalism: I make a thing. It costs me X to make that thing (research, development, marketing, paying the janitor, whatever). You are willing to pay Y for my thing. If I try to charge you 2Y for my thing, you don't buy it, so I charge you Y. Part of my X was also figuring out everyone's Y so I can sell more of my things and still make the maximum amount of money. Y is the "value" of my thing. If I'm smart and made a good thing, Y>X and I pocket the difference and everyone goes home happy.

Now pretend that my thing is a drug. Let's say an antibiotic because most people get that. You get pneumonia and the doctor tells you that you need to buy my thing, and if you don't buy my thing, you might die. For the sake of argument you have pneumonia for which only my thing will work. It still costs me X to make it. But what is your Y? Is there a cost at which you say "no I can live without this." There probably isn't, and if you do have an upper bound on your Y, it's probably very high. You are probably willing to go into debt, borrow from your family, or beg on the street, to get this medication you (or if substituting "your child" makes it more real) might die without. And indeed we find- that is exactly what people do! They hold fundraisers, max out every credit card, and do a lot of things that we would consider tacky if they were raising money for a wedding, but seem perfectly acceptable when someone needs life saving treatment.

So this is where socialism can make a difference. We as a society decide: I want to be healthy. I want my neighbor to be healthy. It is good for society if we can all be healthy. I don't want anyone to go without a potentially life saving treatment because they can't afford it. That's us deciding that healthcare is a "right" and not a "privilege." So then the first step is to go, as a group, hey- we know that you made the things and it cost X. But since there is such a high intrinsic value (Y) of your thing and you have us in a really vulnerable position- we are going to come together and say that we are NOT going to pay Y, we are going to pay A. A-X is still a significant profit and we want you to make money bs continue to do research and development, but we have decided as a society that the cost of doing business with our country is that you will take A, and not try and see how close to Y you can get.

Tldr- capitalism in the health care system causes price gouging because we are willing to pay extraordinary sums for treatment

LadyMillil · September 2015

onefootinthebayou said:

huskypuppy14 said:

kkitkat79 said:

I don't think there is anything wrong with running a business for profit. What is wrong is asking for special protections under the guise of being somehow different. There is no evidence that lack of monopolistic power decreases innovation. There is evidence, however, that monopolistic power leads to industry concentration and less innovation.

The 10 largest drug companies control over one-third of the drug market. Their profit margins are about 30 per cent. They spend about one-third of all sales revenue on marketing - twice what they spend on R&D. So they drive out smaller companies, make more money, and spend less of it on innovation. I don't see how that is a good thing.

How do they drive out smaller companies? Innovation also comes from academics too.

What does happen is the start ups do the innovation, and then the larger companies buy out the smaller companies.

This exactly. And let's not forget licensing deals. There is a whole industry niche dedicated to forming licensing deals between Big Pharma and small biotech. Perhaps a Big Pharma company doesn't want to acquire an entire start-up or biotech but is interested in acquiring rights to one or more of their compounds to bring further into development and/or to market. Now it's the small biotech's turn to bring their brass balls to the negotiating table and negotiate a deal with the Big Pharma company that includes lots of money for development of this compound, milestone payments, etc. Then the Big Pharma company takes the compound through clinical trials (assuming the risk here as well), launches it commercially, and if the small biotech negotiated a good deal, they will continue to receive royalties from a now commercial drug that they could not have had the resources to bring to market without a Baxter or a Bayer or a Purdue's robust wallet. I would hardly call this choking innovation of small biotech. I call it symbiosis.

To add to this. I'm an academic scientist and I work on basic research and pre-clinical development. This means I study something like the mechanism of development of a disease or the way a particular pathogen causes illness. Once I understand how this works I try to develop a way to prevent it, stop it, or reverse the process. My lab has spent 7 years working on something. Not including staff salaries over a millions dollars has been spent on this development. My team has the experience and facilities to do animal testing, but we don't have the hundreds of millions of dollars to move to human trials. Now, say our drug is 100% effective at treating a disease in mice. If we can't sell this product to a biotech company, the human testing will never be done and you will never see this product on the shelves. If a biotech company is interested in my product, that is fantastic. We negotiate, a deal is struck, I go back to my basic research and pre-clinical development to come up with my next invention, my drug goes on to clinical testing and maybe you see it someday.

PrettyGirlLost · September 2015

FeeleyToBe said:

This is already happening with cancer cures I think. My fiance is a Pharmacy Tech and was telling me that because the money is not in the cure but in the treatment, pharmaceutical companies have simply made the few cure drugs completely unaffordable to keep them off the market.

Sad, sad, sad.

P.S. If you're truly upset with Pharmaceutical Greed, look into Bernie Sanders for POTUS.

We already found a cure for the majority of cervical cancers, it's called Gardasil and it's being currently being sold, so your FI's conspiracy theory is wrong right there. No one is withholding cancer cures or treatments to make money off of the dying.

Cancers are complex, multi factorial diseases occurring largely due to an accumulation of deleterious mutations in our DNA, which for the most part accumulate over time as we age. There is no current cure to rid the body of these mutations nor prevent more from occurring over time.

Researchers *are* currently working on many different types of drug treatments and targeted therapies to treat cancer, but those studies take time. There are many phases involved in getting a drug or treatment that is discovered in the lab on an animal model out to actual patients.

Gene therapies are promising, but that technology is not ready for prime time yet, and we still don't know exactly which genes are directly responsible for every form of cancer. . . those studies take years and years to identify genes of interest and then to validate. Not only that, but it's expensive as fuck to conduct and then validate whole genome or exome sequencing studies, which is what is needed to locate mutations. And then so much data is generated- 100's of GBs of data per every patient sample run- that the current analysis technology available to us can't really handle it yet. So new methods have to be developed so we can interrogate the data we are generating, and that takes time too.

TL,DR: Big Pharma withholding the cure for cancer is an absurd conspiracy theory.

kkitkat79 · September 2015

Wegl13 said:

Tldr- capitalism in the health care system causes price gouging because we are willing to pay extraordinary sums for treatment

"Price gouging" in any system is only possible if there is a barrier to free entrance into the market. The more elastic supply is (meaning easy to get in and out of the market) the less "price gouging" can happen.

@novella1186, I never said that size of the company determines the level of innovation. I said that monopoly power determines the level of innovation. More monopoly power means more concentration, higher prices, less innovation. One can definitely argue that the pharma industry is not that monopolized and that the patent system does not in fact lead to more concentration, higher prices, and that it does not affect innovation. I presented evidence that it is highly concentrated, innovation happens less inside the industry than out, and I think we can all agree that the prices are high. Yet, for some reason the thinking persists that the patent system is not the problem, there is enough innovation, and the prices are high because... well, capitalism and "price gouging".

Hey, you all are probably right. There is nothing wrong with the current patent system. It is an essential part of the industry and is necessary to keep everything going. The drug industry is as vibrant, as competitive, and as innovative as it can be. And somehow, even though the industry is very competitive, it is still able to make 30% profit margins. Yes, it must be because we often need medication to survive so we'll pay anything for it which allows for "price gouging". To contrast, food retailers for example (another very competitive industry) operate on 1.5% profit margin. Maybe it's because we don't need food that much so no "price gouging" is possible. After all, we can grow our own food, we cannot make our own medication. That must be it.

lyndausvi · September 2015

Ever heard of supply and demand?

EVERYONE needs food. Not everyone needs medications. Especially a specific medication for something uncommon.

In the last year I've taken 5 steroids, for a cough. That is all as far as prescription medications go. I would say that is about average for me during my lifetime.

DH on the other hand has so many meds I can't even count. He is at the pharmacy almost weekly and he spends about $150-230 per month on prescription medications. That is after the insurance pays their part.

kkitkat79 · September 2015

lyndausvi said:

Ever heard of supply and demand?

EVERYONE needs food. Not everyone needs medications. Especially a specific medication for something uncommon.

In the last year I've taken 5 steroids, for a cough. That is all as far as prescription medications go. I would say that is about average for me during my lifetime.

DH on the other hand has so many meds I can't even count. He is at the pharmacy almost weekly and he spends about $150-230 per month on prescription medications. That is after the insurance pays their part.

I am not sure I follow you. Are you saying that in a competitive industry with lower demand prices will necessarily be higher?

ETA: It does not matter how many buyers and sellers you have. The important things is that relative to each other there need to be a lot of buyers and sellers so that no one group holds price-setting or quantity setting power.

TrixieJess · September 2015

kkitkat79 said:

lyndausvi said:

Ever heard of supply and demand?

EVERYONE needs food. Not everyone needs medications. Especially a specific medication for something uncommon.

In the last year I've taken 5 steroids, for a cough. That is all as far as prescription medications go. I would say that is about average for me during my lifetime.

DH on the other hand has so many meds I can't even count. He is at the pharmacy almost weekly and he spends about $150-230 per month on prescription medications. That is after the insurance pays their part.

I am not sure I follow you. Are you saying that in a competitive industry with lower demand prices will necessarily be higher?

Yeppers.

emmaaa · September 2015

TrixieJess said:

kkitkat79 said:

lyndausvi said:

Ever heard of supply and demand?

EVERYONE needs food. Not everyone needs medications. Especially a specific medication for something uncommon.

In the last year I've taken 5 steroids, for a cough. That is all as far as prescription medications go. I would say that is about average for me during my lifetime.

DH on the other hand has so many meds I can't even count. He is at the pharmacy almost weekly and he spends about $150-230 per month on prescription medications. That is after the insurance pays their part.

I am not sure I follow you. Are you saying that in a competitive industry with lower demand prices will necessarily be higher?

Yeppers.

Basic Econ 101

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